How much rates vary
Facilitymedian $27 · 10th to 90th $20 to $389Professionalmedian $21 · 10th to 90th $17 to $34
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $26.92 | Facility | None | $16.60 | $16.60 | $26.92 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $20.42 Typical High $20.42 | Professional | None | $16.60 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $2.45 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.62 | $2.04 | $2.04 |
Ambetter Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
AmeriHealth Setting Facility Modifier None Typical Low $186.21 Median $295.12 Typical High $501.19 | Facility | None | $186.21 | $295.12 | $501.19 |
AmeriHealth Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Capital Blue Cross Setting Facility Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $79,432.82 | Facility | None | $4,265.80 | $5,011.87 | $79,432.82 |
Capital Blue Cross Setting Professional Modifier None Typical Low $26.92 Median $33.88 Typical High $33.88 | Professional | None | $26.92 | $33.88 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $12.59 Median $21.38 Typical High $21.38 | Facility | None | $12.59 | $21.38 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $165.96 | Professional | None | $18.20 | $18.20 | $165.96 |
Emblem Health Setting Professional Modifier None Typical Low $31.62 Median $50.12 Typical High $58.88 | Professional | None | $31.62 | $50.12 | $58.88 |
Geisinger Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Geisinger Setting Professional Modifier None Typical Low $16.98 Median $20.42 Typical High $33.88 | Professional | None | $16.98 | $20.42 | $33.88 |
Highmark BCBS Setting Facility Modifier None Typical Low $38.02 Median $147.91 Typical High $223.87 | Facility | None | $38.02 | $147.91 | $223.87 |
Independence Blue Cross Setting Facility Modifier None Typical Low $186.21 Median $295.12 Typical High $501.19 | Facility | None | $186.21 | $295.12 | $501.19 |
Independence Blue Cross Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Martin's Point Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $26.92 | Facility | None | $16.60 | $16.60 | $26.92 |
Martin's Point Setting Professional Modifier None Typical Low $16.60 Median $20.42 Typical High $20.42 | Professional | None | $16.60 | $20.42 | $20.42 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $3.09 Typical High $3.09 | Professional | 55 · Aftercare only | $2.45 | $3.09 | $3.09 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $1.62 | $2.04 | $2.04 |
Oscar Health Setting Professional Modifier None Typical Low $22.91 Median $34.67 Typical High $51.29 | Professional | None | $22.91 | $34.67 | $51.29 |
UPMC Health Plan Setting Facility Modifier None Typical Low $25.12 Median $109.65 Typical High $186.21 | Facility | None | $25.12 | $109.65 | $186.21 |
UPMC Health Plan Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $31.62 | Professional | None | $25.12 | $25.12 | $31.62 |
United Setting Professional Modifier None Typical Low $13.18 Median $16.60 Typical High $28.18 | Professional | None | $13.18 | $16.60 | $28.18 |
2 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | KX · Policy requirements met | $25.70 | $25.70 | $25.70 |
Highmark BCBS Setting Professional Modifier KX · Policy requirements met Typical Low $23.44 Median $25.12 Typical High $33.88 | Professional | KX · Policy requirements met | $23.44 | $25.12 | $33.88 |
Where Pennsylvania sits
The same service costs 2.6 times more in Hawaii than in New Hampshire. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Pennsylvania· 29th of 51
$21.38
HI $41.69NH $15.85
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.